What Are the Risks of the NEUROMARK® Procedure?

NEUROMARK® has an excellent safety profile. The most common experience following the procedure is mild temporary discomfort, and throat numbness that resolves within 30 to 60 minutes. Empty nose syndrome is not a risk — no mucosal surface is removed. No patient at SAWC has reported a nose that became excessively dry following the procedure.

By Dr. Franklyn Gergits, ENT · Sinus & Allergy Wellness Center of North Scottsdale · SinusAndAllergyWellnessCenter.com

When patients consider NEUROMARK®, one of the first questions they ask is about risk. That is exactly the right question to ask, and it deserves a complete and honest answer — not a brochure summary. What follows is the same conversation I have with every patient before we proceed.

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The Most Common Experience — Mild Discomfort in Specific Patients

The most frequently reported post-procedure experience at SAWC is mild discomfort — and even this is not universal. The patients who are most likely to notice it are those who have had extensive prior endoscopic sinus surgery, where the surgical resection of normal anatomical landmarks makes delivering local anesthesia to the precise posterior nasal locations more technically challenging.

When normal anatomy has been altered by prior FESS, the usual reference points I rely on to place anesthetic precisely are changed or absent. Early in our NEUROMARK® experience, this created cases where anesthesia was less complete than ideal. We have since developed improved anesthesia protocols specifically for the post-surgical nose — additional steps, modified injection points, and a longer anesthesia dwell time — that have substantially addressed this challenge. Patients with a history of prior sinus surgery should let us know at their evaluation so we can plan accordingly.

Throat Numbness — Temporary and Manageable

Some patients notice throat numbness following the procedure. This occurs when the topical anesthetic gel used during the preparation phase migrates posteriorly into the nasopharynx and oropharynx. It is temporary, typically resolving within 30 to 60 minutes as the medication wears off.

While the throat is numb, there are two practical things to be aware of. First, avoid hot beverages. The numbness removes your ability to sense temperature accurately — so that hot coffee from Starbucks on your way home could burn your throat before you realize it. If you have your heart set on coffee after the procedure, ask for it at room temperature, or in Arizona, an iced coffee is a perfectly reasonable solution. Second, when you do drink anything, start with baby sips. The numbness temporarily affects not just sensation but also the coordination of swallowing — the muscular sequence that moves a liquid safely from your mouth to your stomach. Small sips give your swallow reflex time to work without being overwhelmed. Once the medication has fully worn off, there are no restrictions on food, beverages, or temperature.

Empty Nose Syndrome — Why It Is Not a Risk Here

Empty nose syndrome is one of the most feared complications of nasal surgery, and for good reason — it is a devastating condition in which patients paradoxically feel unable to breathe despite a wide open nasal airway, caused by the surgical removal of too much turbinate tissue. Patients ask about it often, and the concern is completely understandable.

NEUROMARK® does not carry this risk. Empty nose syndrome occurs because mucosal surface area is physically eliminated — the sensory receptors that register airflow, temperature, and humidity are removed along with the tissue. NEUROMARK® does none of this. The radiofrequency energy down-regulates nerve activity. It does not excise, destroy, or lyse the nerves. It does not remove any mucosal surface. The tissue remains. The receptors remain. The architecture of the nasal cavity is entirely unchanged. The nerve activity is simply modulated to a lower, healthier baseline.

In my clinical experience at SAWC, not a single patient has reported a nose that became excessively dry or that lost the normal sense of airflow following NEUROMARK®. Drainage is reduced — that is the goal — but it is not eliminated. The nose continues to function normally. It simply stops overproducing.

What the Published Literature Shows

Across the published clinical trials and multicenter studies on radiofrequency posterior nasal nerve treatment, serious adverse events have not been reported. Minor adverse events — including temporary discomfort, mild swelling, and transient changes in sensation — occurred in approximately 7.4% of patients across the published literature and resolved without intervention. No permanent loss of nasal function, no structural damage, and no cases of empty nose syndrome have been reported in the published evidence base for this device class.

NEUROMARK® is an FDA-cleared device. The radiofrequency energy delivery is pre-set and calibrated — it is not adjustable in the moment, which means there is no risk of inadvertent over-treatment from operator error in the energy delivery itself.

Having an Honest Conversation at Your Evaluation

The best way to understand your personal risk profile is to have a complete conversation at your evaluation. Patients with prior sinus surgery, significant anatomical variations, or complex medical histories may have a different pre-procedure preparation than straightforward cases — and that is something we plan for specifically, not something we discover during the procedure. At SAWC, the evaluation is where we make those determinations, and where you get answers to every question you bring with you.

Want to Understand More?

This post is part of the Understanding Your Symptoms series on the Airway & Sinus Wellness Review.

→ What Is NEUROMARK® — and Could It Stop Your Chronic Runny Nose?

→ Is Balloon Sinuplasty Painful?

→ Will Balloon Sinuplasty Correct My Post-Nasal Drainage?

→ Is the Combination Procedure Too Much?

→ Airway & Sinus Wellness Review — Full Publication

Understanding Your Symptoms — Clinical education from the Sinus & Allergy Wellness Center of North Scottsdale.

About the Author

Dr. Franklyn R. Gergits, DO, MBA, FAOCO is an osteopathic otolaryngologist and otolaryngic allergist with a focus in rhinology with over 30 years of clinical experience treating sinus and airway disease in Scottsdale and the greater Phoenix metropolitan area. He is the founder of the Sinus & Allergy Wellness Center of North Scottsdale and performed the first balloon sinuplasty in Pennsylvania. He holds dual Entellus Centers of Excellence certifications and specializes in comprehensive, personalized, office-based nasal and sinus care — including balloon sinuplasty, NEUROMARK® posterior nasal nerve treatment, Eustachian tube dilation, nasal airway surgery, and comprehensive allergy testing and immunotherapy. Dr. Gergits is the originator of the Posterior Sinonasal Syndrome (PSS) hypothesis — a clinical framework identifying pepsin-mediated posterior nasal mucosal injury as an upstream driver of chronic rhinosinusitis. ORCID: 0009-0000-4893-6332. Preprint DOI: 10.20944/preprints202603.0858.v1. Dr. Gergits has no financial relationship with Neurent Medical.

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This content is for educational purposes only and does not constitute medical advice. Please consult a qualified physician for evaluation and treatment of your specific condition. NEUROMARK® is a registered trademark of Neurent Medical.